Provider Demographics
NPI:1720066053
Name:TONKS, SHARI M (MD)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:M
Last Name:TONKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 344054 MCMILLAN ROAD
Mailing Address - Street 2:
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29634-4054
Mailing Address - Country:US
Mailing Address - Phone:864-656-2233
Mailing Address - Fax:864-656-1619
Practice Address - Street 1:735 MCMILLAN ROAD
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29634-9729
Practice Address - Country:US
Practice Address - Phone:864-656-2233
Practice Address - Fax:864-656-1619
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36303207QS0010X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
207RS0010XOtherTAXONOMY
OHP00146191OtherMEDICARE RAILROAD
OHP00146191OtherMEDICARE RAILROAD
OH0176590Medicaid
OHTO0787593Medicare PIN